Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Int J Oral Maxillofac Surg. 2012 Feb;41(2):160-7. doi: 10.1016/j.ijom.2011.10.001. Epub 2011 Nov 17.
Literature regarding the outcome of maxillary sinus floor elevation to create sufficient bone fraction to enable implant placement was systematically reviewed. Bone fraction and implant survival rate were assessed to determine whether grafting material or applied growth factor affected bone fraction. Trials where sinus floor elevations with autogenous bone (controls) were compared with autogenous bone combined with growth factors or bone substitutes, or solely with bone substitutes (test groups) were identified; 12 of 1124 fulfilled all inclusion criteria. Meta-analyses comparing the bone fraction after applying: autogenous bone; autologous bone with growth factors (platelet rich plasma); or autogenous bone and bone substitutes (bovine hydroxyapatite, bioactive glass, corticocancellous pig bone) revealed no significant differences in bone formation after 5 months. A significantly higher bone fraction was found in the autogenous bone group compared to the sole use of β-tricalciumphosphate (P=0.036). The one-year overall implant survival rate showed no significant difference between implants. Bone substitutes combined with autogenous bone provide a reliable alternative for autogenous bone as sole grafting material to reconstruct maxillary sinus bony deficiencies, for supporting dental implants after 5 months. Adding growth factors (platelet rich plasma) to grafting material and the sole use of β-tricalciumphosphate did not promote bone formation.
对旨在提升上颌窦底以产生足够骨量以支持种植体植入的研究进行了系统性回顾。评估了骨量和种植体存活率,以确定移植物材料或应用的生长因子是否会影响骨量。研究中,将自体骨(对照组)提升的上颌窦与自体骨联合生长因子或骨替代物,或仅与骨替代物(实验组)进行了比较;满足所有纳入标准的试验有 12 个,共 1124 个。对应用以下材料后的骨量进行了荟萃分析:自体骨;含生长因子(富血小板血浆)的自体骨;或自体骨和骨替代物(牛羟磷灰石、生物活性玻璃、皮质松质猪骨),发现 5 个月后,骨形成没有显著差异。与单独使用β-磷酸三钙相比,自体骨组的骨量明显更高(P=0.036)。一年总的种植体存活率显示,种植体之间没有显著差异。骨替代物联合自体骨可为重建上颌窦骨缺损提供一种可靠的替代自体骨的方法,可在 5 个月后支持牙种植体。在移植物材料中添加生长因子(富血小板血浆)和单独使用β-磷酸三钙并不能促进骨形成。